Results have been varying with only one study reportedly alleging the effectiveness of HBOT on autistic patients. In this study by Dr. Annie Tanasugarn, an 8-year-old autistic child showed significant improvement in communication skills around the 8 th week of receiving regular HBOT, three times each week for one hour per session.
The number of HBOT sessions required for autistic patients varies from person to person. Some people need more sessions, some people need less. Treatment with HBOT has been shown to possess potent anti-inflammatory properties in both animal [ 71 - 73 ] and human studies [ 74 - 78 ].
HBOT has been reported to decrease the production of pro-inflammatory cytokines including TNF-alpha, interferon-gamma, IL-1 and IL-6 in both animal [ 79 , 80 ] and human studies [ 78 , 81 ] as well as increase counter-inflammatory IL levels [ 82 ]. In one study, HBOT also decreased neopterin levels [ 83 ]. The effect of HBOT on reducing inflammation may be mediated through a pressure-related effect and not necessarily by the oxygen delivered.
For example, one human study reported a reduction in interferon-gamma production by lymphocytes with HBOT at 2. In the first study, 12 children received HBOT at 1. Biomarkers were measured before and after 40 HBOT sessions [ 85 ]. Children who had the highest C-reactive protein levels showed the largest decrease. In the second study, plasma cytokine levels, including some associated with inflammation, were measured before and after 80 HBOT sessions delivered at 1.
Behavioral improvements were observed in these children, but the study reported no significant changes in cytokines during the study. However, the authors noted that none of the children had abnormal cytokine levels at the beginning of the study, making it less likely that a significant change could be observed. Furthermore, since cerebrospinal fluid CSF cytokine abnormalities have been reported in some children with ASD [ 64 , 87 , 88 ], the authors noted that CSF cytokines could have changed.
However, CSF cytokines were not measured in the study. Further studies of HBOT in children with ASD who have abnormal cytokines and markers of inflammation are warranted to investigate these findings in more depth.
In addition to these two studies, one of the authors DAR has observed a decrease in urinary neopterin levels after HBOT in some children. Another child with ASD who had significant eczema and bowel inflammation with abdominal distension had resolution of eczema, chronic diarrhea and abdominal distension with HBOT at 1. Before HBOT, physical exam reveals distended abdomen a with chronic diarrhea. After HBOT, patient has improvements in distended abdomen b and bowel movements. Figure use with parental permission.
Some individuals with ASD manifest evidence of mitochondrial dysfunction [ 34 , 89 ]. A recent review article reported that publications implicated mitochondrial dysfunction in ASD [ 38 ]. Although treatments for mitochondrial dysfunction remain relatively limited [ 34 ], interest has recently increased in using HBOT as a potential treatment.
Both animal and human studies have examined the effects of HBOT on mitochondrial function. Several animal models have reported improvements in mitochondrial function with HBOT [ 90 - 96 ]. For example, in one study of rats with normal mitochondrial function, HBOT increased the production of ATP in muscle tissue compared to a control group [ 97 ].
A recent study of rat hippocampus reported that HBOT increased mitochondrial biogenesis and autophagy through, in part, an increased production of reactive oxygen species ROS. Through this process, new healthy mitochondrial were produced and old dysfunctional mitochondrial were destroyed. Although one investigator has reported improvements using HBOT in children with concomitant mitochondrial disease and ASD [ 99 ], no clinical studies have been published to date examining the effects of HBOT on mitochondrial function in individuals with ASD; further study in this area is needed.
Multiple studies have reported evidence of oxidative stress in children with ASD [ 36 , - ]. A recent review article reported that publications implicated oxidative stress in ASD [ 38 ].
Since some children with ASD have evidence of elevated oxidative stress [ 38 , ], some investigators have expressed concern that HBOT could increase oxidative stress in this subset of children [ 85 ].
Theoretically, HBOT might increase oxidative stress through the augmented production of ROS from the high concentration of oxygen [ ]. This may occur because increased oxygen delivery to mitochondria can increase ROS production. However, HBOT has been shown to upregulate the production of antioxidant enzymes such as superoxide dismutase [ , ], glutathione peroxidase [ ], catalase [ ], paraoxonase [ ] and heme-oxygenase 1 [ , ]. Interestingly, increasing ROS may be a potential mechanism of action of HBOT because ROS play an important role in cellular signaling and in triggering certain metabolic pathways [ ].
In the first study, HBOT was administered daily at 1. SOD was 4. Mean catalase increased by 1. Finally, mean glutathione peroxidase increased by 1. The effects of HBOT on these antioxidant enzymes may be an example of conditioning as previously discussed. Behavioral improvements were observed in these children and plasma oxidized glutathione levels did not significantly change at 1.
Since oxidized glutathione is exported from cells when intracellular levels exceed the redox capacity [ ], this finding suggests that intracellular oxidative stress did not significantly worsen with HBOT at these two commonly used lower HBOT pressures in ASD [ 85 ].
These behavioral studies can be divided into those with and without control children. The number of treatments and other HBOT parameters were not reported. In , Heuser et al. This child also had chronic diarrhea and had the first normal bowel movement in his life with HBOT treatment [ 99 ].
In another report, 23 patients with ASD had various improvements in social interaction, language and repetitive behaviors with HBOT at 1. Finally, one prospective study of 20 children with ASD reported improvements in communication, social interaction and stereotypical behaviors after 20 HBOT sessions at 1. Pictures courtesy of Carol L. Henricks, MD. Pictures courtesy of James Neubrander, MD.
More significant improvements were observed in children under age 5 compared to those older. Twelve children were treated at 1. Hyperbaric sessions were 45 minutes in duration for 40 total sessions. As previously noted, markers of oxidative stress and inflammation were measured. Strengths of this study included the prospective nature and the use of objective measurements oxidative stress and inflammatory markers.
One group of investigators criticized this study, stating that significant improvements were only observed when both groups 1. One small, prospective case series of 3 children with ASD using a multiple baseline design reported no significant improvements compared to baseline after 27—40 HBOT treatments at 1.
However, one child had an increase in spontaneous communication and another child had a decrease in problem behaviors with HBOT and an immediate increase in problem behaviors when HBOT was stopped [ ].
These improvements were felt by the authors to be unrelated to HBOT but could not necessarily be explained by other factors. Strengths of this study included the prospective nature, the multiple baseline design including a baseline prior to initiating HBOT , as well as evaluations by therapists and videotaping. Strengths of this study included the prospective nature and the objective measurements of self-help and motor skills by therapists.
One prospective study using a multiple baseline design examined the effects of HBOT at 1. The mean frequency of treatments was 4. No consistent positive or negative effects were observed. The authors noted that the study used an observational technique which may not have been sufficient to measure changes in certain areas, such as attention and memory, and that the number of treatments per week was about half as other studies which reported improvements using similar HBOT parameters in children with ASD.
Strengths of this study included the multiple baseline design including a baseline prior to initiating HBOT , as well as evaluations by therapists and videotaping. As previously noted, cytokine markers were measured before and after HBOT.
Overall, parents reported improvements in eye contact, imitation, language, tantrums, gastrointestinal problems and eczema.
Strengths of this study included the prospective nature, evaluations by clinicians, and objective measurements cytokine levels. In a recent systematic review published in Medical Gas Research , Ghanizadeh reviewed two randomized, double-blind, controlled trials using HBOT in children with autism [ ].
The first study investigated the effects of HBOT at 1. Of the children completing more than 1 HBOT session, one child dropped out of the study after nine treatment sessions because asthma symptoms worsened, but this was not felt to be related to the treatment.
Ghanizadeh noted that six other children dropped out of the study four before the study began and two before finishing one full treatment. In this study, six medical centers participated and the findings did not significantly differ across centers. Strengths of this study included evaluations by blinded clinicians and parents only the HBOT technician was aware of group assignment , an assessment of blinding which was adequate , an intention-to-treat analysis children finishing more than 1 HBOT session were included in the analysis , the prospective nature, the use of a control group, and the use of 6 centers which may have minimized potential biases associated with a single site study.
Several criticisms of this study [ ] arose in the comments sections of BMC Pediatrics and by other authors [ , ]. One criticism was the claim that the effect of treatment was determined by an intragroup analysis of the treatment group alone, and not by an intergroup analysis of the treatment compared to the control group; however, the analysis was indeed an intergroup analysis where the effects of treatment were compared between the two groups.
Another criticism was that the effect size of the treatment was probably small; however, the effect sizes were calculated as moderate to large 0. In the second controlled study, 18 children with autism were treated with HBOT at 1. Both groups received intensive ABA therapy and no significant changes were reported using several different behavioral scales [ ]. It was not noted if these participants were in the treatment group or the control group or when they dropped out of the study; the scores from these 12 children were not included in the final analyses.
Ghanizadeh [ ] also observed that the number of patients in each group was small and that both groups showed some improvements during the study. Furthermore, it was noted by Ghanizadeh [ ] that since both groups received intensive ABA therapy during the trial, one explanation for the lack of efficacy observed is that HBOT did not add significant therapeutic effects to intensive ABA.
Strengths of this study included the prospective nature, the use of a control group and evaluation by blinded assessors. Ghanizadeh [ ] reported several important distinctions between these two controlled trials [ , ] which might help account for the different outcomes, including the number of participants, potential differences in diagnoses, different age ranges of the study participants, different outcome assessors, possible differences in demographics and autism severity, multicenter [ ] vs.
Ghanizadeh also noted that one [ ] of the studies had a relatively high dropout rate which may have affected the results of the study. Although the other controlled study had 7 children drop out of the study, 4 dropped before starting the study and two before finishing one treatment session [ ].
Moreover, Ghanizadeh noted that for one of the studies [ ], there was no assessment of blinding efficacy as described in other HBOT studies [ , ]. Some studies specifically noted there were no adverse events [ 85 , ]. One study reported no adverse effects except for transient tinnitus in one child which resolved within one week [ ]. Another study reported several non-serious adverse events, including ear discomfort 4 children , ear infections 2 children and for 1 child each: hyperactivity, increased vocal sensitivity, increased sensory needs, insomnia, fatigue, dehydration, irritability, mouthing of objects, and a seizure [ 86 ].
One of the controlled studies reported that one child in the treatment group developed both urinary frequency urinalysis was normal and a skin rash that the treating physician thought was yeast-related. Another child in the treatment group had worsening of asthma symptoms after nine treatment sessions and was removed from the study; a third child had anxiety and dropped out of the study before finishing one full treatment.
In the control group, one child developed abdominal distension and diarrhea during the study and another child had worsening of eczema [ ]. The other controlled study reported no adverse events in the treatment group but reported that one of the children in the control group developed hyponatremia and the acute onset of seizures and was removed from the study [ ].
Many of the reviewed studies suffered from limitations, including the lack of control children, an open-label design, a small number of participants, a retrospective design and the use of parent-rated scales. Indeed, there were only two controlled studies that did not suffer from these types of limitations.
These limitations may have contributed to inconsistent findings across studies. Another study conducted by Castelli, et at. Again the research team looked at the functional deficits of a person with autism and compared it to the actual diagnostic deficits happening in the brain. They used a comparison study with ten adults diagnosed with autism and ten people in the control group made up of students and staff recruited from a university.
The participants were shown twelve different brief animations, four different animations from three different types. After viewing, the subjects were questioned about what was happening in the animation.
The results demonstrated a direct comparison on the two groups there was a significant reduction in blood flow velocity in the autism subjects in the basal temporal area, superior temporal sulcus, and the medial prefrontal area. They concluded that people with autism do have impaired brain function with reduction in cerebral blood flow and lack of connectivity, especially evident when subject is mentalizing. One area of possible origin is the Amygdala Castelli, The pathophysiology of children with autism appears to include a number of different brain abnormalities.
However, the area that is most often referred to as the site of the most abnormality is the cerebellum. The cerebellum damage shows consistent area for inflammation and also cell damage. One cell in particular is the Purkinje cell. Not only do multiple studies show a reduction in the Purkinje cell, but also Fatemi and colleagues have shown not only a reduction in the number of Purkinje neurons, but also a reduction in size Fatemi, Chronic, ongoing process of neuroinflammation is a likely source for the reduction of the Purkinje Cells.
Based on the research of Vargas and colleagues the findings of immune responses in the cerebellum were closely associated with degenerating Purkinje Cells, granule cells, and axons. In correlation to thimerosal, a side-effect of ethyl-mercury poisoning is reduction in the number of Purkinje Cells.
These deficiencies are clearly linked to the deficits found in people with autism. Interestingly, neurological effects of mercury on the brain are in the amygdale, hippocampus, basal ganglia, cerebral cortex, damages Purkinje and granule cells in the cerebellum, paralleling the damage found in the autistic brain. The neurological abnormalities manifest as deficits in cerebral blood flow, hypoperfusion, neuroinflammation, and lack of brain synchronization. This is important to understand in order to begin to find ways to treat people with autism, and understand the theory behind the treatment.
This is reflective in the treatment of hyperbaric oxygen therapy. When a person receives hyperbaric oxygen therapy the blood flow in the brain is increased, and hypoxia and inflammation are reduced. Hence, it is reasonable to recognize how hyperbaric oxygen therapy may decrease neurological deficits and reduce symptoms of autism.
The results were phenotypic reversal of the syndrome. Guy et al. No matter the cause of the neuroinflammation the effects can be devastating. However, hyperbaric oxygen therapy may be one answer to addressing the neurological deficits in autism to be treatable.
Research Studies Tami Powell Ph. Facebook Instagram. What is Hyperbaric Oxygen Therapy? Things we need to fix. Things we need to get done. In the same way, our bodies also have a to-do list.
Hyperbaric Oxygen has been shown to: Destroy harmful bacteria Decrease inflammation Produce new collagen Increase white blood cells Regenerate bone Stimulate capillary growth Strengthen the immune system Help mitochondrial function And perhaps most amazing of all, it even creates new stem cells in the body.
Schedule a Discovery Session. Attacks a Root Cause of Autistic Behavior Studies have shown promising results by using Hyperbaric Oxygen Therapy to reduce the inflammatory symptoms associated with Autism in the brain and gastrointestinal system along with bringing actual healing to those damaged systems.
First, it removes toxins, such as heavy metals from the body. It reduces inflammation allowing oxygen-deprived areas to have a return of blood flow. It builds new capillaries in the brain. It reduces the inflammation in the gut. What do parents of children with ASD report? Hawaiian ASD study Hawaii has more autism per capita than any other state. The study consisted of 20 children, 4 female and 16 male.
The history of hyperbaric Though Hyperbarics has received a greater amount of attention in recent years, the therapy has been utilized for over years. Read More ». Powell S pecific Aims Eliminating the behaviors associated with children having autism would save this country millions of dollars and improve the lives of countless people. Medically When studying peer reviewed research in autism, it is clearly a medical condition. Review of the Literature Brain Research—Hypoperfusion When a typical person focuses on a task or generates speech, the brain is doing more work and there is an increase perfusion with the blood flow to the brain.
Ohnishi, In order to look further into hypoperfusion, specifically in the temporal lobe, Zilbovicius and colleagues conducted a study using a PET scan.
Critchley, Similiar to Critchley, Ohnishi and colleagues also reported reduced cerebral blood flow in people with autism. Ohnishi, Another study linked the reduction in cerebral blood flow to damage in the cerebellum that is often found in people with autism. Who is hyperbaric oxygen therapy for? What is hyperbaric oxygen therapy used for? Where does hyperbaric oxygen therapy come from?
What is the idea behind hyperbaric oxygen therapy for autistic children? What does hyperbaric oxygen therapy involve? Does hyperbaric oxygen therapy work? Who practises hyperbaric oxygen therapy?
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